Effectiveness of Routine Comorbidity Screening in HFpEF Outpatients

Overview

In a cohort of 501 HFpEF outpatients, routine standardized comorbidity screening identified one additional comorbidity per patient beyond the three already known, most commonly sleep apnoea and iron deficiency. Despite high prevalence, many comorbidities such as diabetes, hypercholesterolaemia, and obesity were suboptimally treated according to guidelines.

Background

Heart failure with preserved ejection fraction (HFpEF) is a complex syndrome with rising prevalence and high mortality, often complicated by multiple comorbidities. These comorbidities contribute significantly to disease progression and outcomes, yet current guidelines primarily focus on HF with reduced ejection fraction and lack clear recommendations for routine comorbidity screening in HFpEF. Comprehensive screening may improve detection and management of these conditions, potentially enhancing patient care and prognosis.

Data Highlights

Key Findings

• Routine standardized screening in HFpEF patients identified one additional comorbidity per patient beyond those previously known.
• Sleep apnoea and iron deficiency were the most frequently newly diagnosed conditions, affecting approximately one-third of patients.
• Hypertension, sleep apnoea, atrial fibrillation, iron deficiency, and obesity were the most prevalent comorbidities overall.
• Existing comorbidities such as diabetes, hypercholesterolaemia, and obesity were often inadequately managed according to guideline recommendations.
• Systematic screening enables improved detection of hidden comorbidities, facilitating personalized and effective management strategies.

Clinical Implications

Clinicians managing HFpEF patients should incorporate routine comprehensive comorbidity screening to uncover undiagnosed conditions like sleep apnoea and iron deficiency. Addressing the suboptimal treatment of prevalent comorbidities such as diabetes and obesity is essential to optimize patient outcomes. Personalized management targeting comorbidities alongside HFpEF therapy may improve prognosis and quality of life.

Conclusion

Routine comprehensive screening for comorbidities in HFpEF outpatients significantly enhances detection of additional health problems and reveals gaps in current management. Integrating systematic screening into clinical practice supports personalized care and may improve clinical outcomes in this complex patient population.

References

1. Verwerft et al. 2023 -- Towards a standardized diagnostic and therapeutic pathway for suspected heart failure with preserved ejection fraction in European Dyspnoea Clinics